This effort is aimed at developing an effective, easily utilized, and unified system for performing periodontal minimally invasive surgery. Periodontal minimally invasive surgery (MIS) is a method for regenerating lost bone and tooth support resulting from periodontal disease.2-6 MIS utilizes much smaller incisions than traditional periodontal surgery, has a record of clinical regeneration of lost tissue, results in less patient trauma, less postoperative pain, better post surgical esthetics, and a more rapid return to normal function. Periodontal minimally invasive surgery is currently in use but no surgical instrument system exists that allows a surgeon to easily incorporate MIS into their surgical routine. The development of a unified MIS instrument system will consist of: (1) The fabrication of an endoscope visualization system that overcomes the clinical difficulties encountered with current visualization systems and (2) the fabrication of instruments for improved soft tissue debridement through the small surgical opening used with MIS. The long term goal is to produce a commercially available unified surgical instrument system for performing MIS. This system will allow the surgeon to easily perform MIS and will bring to the patient the advantages of MIS. The commercial potential for such a system is very high because of patient desire for the smallest and least invasive surgery possible. The commercial potential will expand as new bioengineered materials, currently under development, become available. The Phase 1 effort will build on existing bench top prototypes developed by Dental Designs of Dallas. Flexible medical endoscopes will be modified for use in MIS. Methods for soft tissue debridement will be developed by completely redesigning the currently available instrumentation (D'granulator, patent held by Dental Designs of Dallas) and the adaptation of medical ultrasonic "chopper" technology (Phacoemulsifier for cataracts). The developed prototypes will be evaluated in the laboratory by a group of periodontal surgical consultants who currently use MIS or who are leading, published, periodontal surgeons. The resulting system, based on the surgical consultants evaluations and scores, will be used in a Phase 2 multicenter controlled clinical evaluation of MIS. [unreadable] [unreadable] [unreadable]